Background
Dementia and deliberate self-harm represent substantial public health burdens in the older population. However, the health outcomes, referral pathways and predictors of death are not well understood. Late-life depression has been linked to dementia and deliberate self-harm. The growing aging population, along with the high prevalence of depression in older adults has significant implications for the planning and equipping of health services to meet the needs of affected individuals. Depression is ranked as the single largest contributor to global disability and is a major contributor to mortality including suicide. In 2017, the highest age-specific suicide rate in NSW was among males aged ≥85 calling for urgent action to address the public health issue of suicide in older men.
This project aimed to reveal important targets for future detection, prevention, treatment and management, and to further show avenues how to prepare the service system for the needs of this growing population.
Project members
Dr Simone Reppermund Professor Julian Trollor,Professor Brian Draper (School of Psychiatry), Dr Rachael Cvejic, Dr Preeyaporn Srasuebkul, Dr Adrian Walker,
Project aims
Our project aimed to:
- Establish and characterise a population-based cohort of individuals with dementia and self-harm in NSW, including sociodemographics, physical and mental health comorbidities and related service use before and after self-harm. We will also explore the reverse relationship of self-harm being a predictor of dementia diagnosis by looking at people who self-harmed and subsequently developed dementia.
- Determine predictors of death in people with dementia who self-harmed. Predictors of death include physical and mental health comorbidities, sociodemographics, and their interaction. We will also focus on factors indicating increased complexity including number of involuntary admissions to a psychiatric unit and severity of mental illness (indicated by frequency of admissions and treatment intensity).
- Build a large linked dataset of people with dementia who self-harmed for future study, enabling investigation into:
- Costings of emergency department and inpatient stays and their predictors
- Whole of health care and transitions, with linkage to other Commonwealth. datasets (e.g. Pharmaceutical Benefits Scheme for medicines use, Medicare Benefits Schedule for primary care, allied health and specialist care data and National Aged Care Clearinghouse).
Publications
- Risk factors for dementia and self-harm: a linkage study, Alzheimer's & Dementia, 1 May 2023, https://doi.org/10.1002/alz.13080
- Summary of the research with recommendations for people living with dementia and their carers
- Summary of the research with recommendations for health and disability professionals
Dr Adrian Walker, who is also a member of the project team, received an award from the Health Services Research Association of Australia & New Zealand for his publication produced as part of this project. Read more.
